What would you do? — The Bump
Infertility Veterans

What would you do?

I have a friend IRL who is also dealing with IF.  She will be 42 this year and has done 2 failed IVF cycles (one cycle was cx due to lack of response)

She was planning to do a DE cycle and had her FSH level checked it was a 9...she had it check a year ago and it was a 20.  Her RE said they should start a cycle with her OEs now.  She has agreed and is very excited.  Fwd to today, had brunch with some friends, one is an Ob/Gyn.  I was telling her about my friend and she said once you have an elevated FSH, even if the numbers go down it doesnt matter.  She did say that she could possibly still get pregnant but all her training says that she will not.

You guys know how hard a failed cycle is financially and even harder emotionally.  Do I tell my friend what my dr friend said?  I feel like if there is a chance it could work, who am I to say anything.  I also feel like my Ob/Gyn, although a great Dr isnt a RE and if the RE of my IF friend didnt have a concern, who am I to say anything...I am FAR from being a dr of anything.

Thoughts?

I am AMA and all tests on H came back normal
3 failed IVF with OE and 2 failed frozen DE cycles
Last fresh hail mary DE cycle starting Feb 2013
PAIF/SAIF always welcome

Re: What would you do?

  • That's a toughie... is your friend all OOP?
    TTC since 7/2008

    IVF #1 ~ 6/2010 BFN

    IVF #2 ~ 8/2010 BFP! missed m/c @ 9w3d, D&C

    IVF #3 ~ 3/2011 BFN

    DE IVF - ET 6/21 - 2 blasts transferred, 13 frosties

    5dp5dt = 56 11dp5dt = 1604 14dp5dt = 6256

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  • I tend to think that her RE knowing her history and her health would know best how to advise her. The OB may know some things antecdotally, but that is not her specialty, and she is not her patient. I have heard the same things on this board and if I were in your situation, I might mention it in general not as an expert opinion so she could maybe ask her RE, but that would be the extent. Positivity is so hard to come by in IF that I wouldn't want to take that away if she has already made the decision. GL
    imageimage

    Dx: DH - Azoo, Me - Mild PCOS
    DH - sperm found! Seems to produce only for a few days every 70 days!
    Over 1 million in cryo in 15 vials over 6 samples
    IVF #1 - 1 beautiful expanded blast transferred, 4 snowbabies - beta #1 11/30/11 = BFFN
    FET #1, transfered 2 embies 2/16/12 = BFFN; 1 snowbaby left in cryo
    IVF #2 + CGH = 4 genetically normal embies on ice. FET September 26th
    SAIF/PAIF always welcome

    a special GL and prayers to my IF sister Gregermis

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  • yes she is OOP.

    Scuba... I agree with you.  I thought that if it were me, I would not want to know and might even feel resentful.  I agree when you cycle you need all the positive thoughts.  I just pray it does work for her...we all deserve to make it to the other side.

    I am AMA and all tests on H came back normal
    3 failed IVF with OE and 2 failed frozen DE cycles
    Last fresh hail mary DE cycle starting Feb 2013
    PAIF/SAIF always welcome
  • I think I agree with SCUBA's assessment.  Fx for your friend!
    TTC #1 Since 4/2010, Cycle 30
    Positive for HLA-B27, I'm a mutant :p
    Testing - Me ok, gluten issue? DH - borderline count, low motility
    4/28/11 IUI#1 = BFP!(5/25), EDD 2/2/12 - m/c 5w3d
    7/3, 7/31, 9/25 - IUI#2-4=BFN
    IVF#1 - 1 blast = BFP!! (12/30), EDD 9/9/12, confirmed c/p 4w2d
    FET#1 3/2/12 - 2 blasts =BFP!! EDD 11/18/12, us#1 = twins! Confirmed m/c 5w6d
    4/20-surprise BFP and another c/p 4w2d
    FET#2 7/16/12 - 2 blasts = BFN
    FET#3 8/20/12 - 1 blast - BFP!! Beta #1-2=177, 354
    1st u/s 5w6d, one beautiful little HB :), 2nd u/s 146bpm
    baby girl born 5/10/13

    TTC#2 since 12/17/2014, Cycle 8
    Repeat Testing...FSH=12, AMH=3.8, AFC=28. 
    IUI#5 5/10/15- c/p?
    IVF#2 8/19/15 - cancelled due to cysts
    IVF#2 take two 10/2015 - 5 blasts frozen
    FET#4 12/11/2015 - BFN - 4 blasts remaining
    FET#5 2/18/16 - BFP!!!  Beta1-3, 126, 250, 745!!

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    Tons of love and ((hugs)) to my IF sister NMscubagirl


  • One thing I forgot to add, her husband was an expat so her 2 ivf's were done out of the country.  She has not ever cycle with her current RE.
    I am AMA and all tests on H came back normal
    3 failed IVF with OE and 2 failed frozen DE cycles
    Last fresh hail mary DE cycle starting Feb 2013
    PAIF/SAIF always welcome
  • And a new RE might be just the trick. Good luck to your friend.
    TTC since 7/2008

    IVF #1 ~ 6/2010 BFN

    IVF #2 ~ 8/2010 BFP! missed m/c @ 9w3d, D&C

    IVF #3 ~ 3/2011 BFN

    DE IVF - ET 6/21 - 2 blasts transferred, 13 frosties

    5dp5dt = 56 11dp5dt = 1604 14dp5dt = 6256

    <a href="http://lilypie.com/"><img src="http://lpmf.lilypie.com/GnJdm8.png" width="400" height="80" border="0" alt="Lilypie Premature Baby tickers" /></a>
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  • Once the FSH number has a high reading like that it indicates DOR.  Even when it goes down, it doesn't mean that ovarian reserve has changed.  You are still working with the same number of eggs.  Having said this, it doesn't mean that she can't get pregnant.  Mine was close to 19 when it was tested two years  ago so it could have been even higher when I got pregnant.  It is possible to get KU, just less likely than someone who doesn't have egg issues.  I assume that her RE has gone over the chances.  If it were me, I would not say anything to my friend.  I would just tell her that I am there for her, as I'm sure you are.  Best of luck to her.
  • image Mrkyrain:
    Once the FSH number has a high reading like that it indicates DOR.  Even when it goes down, it doesn't mean that ovarian reserve has changed.  You are still working with the same number of eggs.  Having said this, it doesn't mean that she can't get pregnant.  Mine was close to 19 when it was tested two years  ago so it could have been even higher when I got pregnant.  It is possible to get KU, just less likely than someone who doesn't have egg issues.  I assume that her RE has gone over the chances.  If it were me, I would not say anything to my friend.  I would just tell her that I am there for her, as I'm sure you are.  Best of luck to her.

    Yes  Thanks!!

    I am AMA and all tests on H came back normal
    3 failed IVF with OE and 2 failed frozen DE cycles
    Last fresh hail mary DE cycle starting Feb 2013
    PAIF/SAIF always welcome
  • I agree that I wouldn't say anything to her. Being a little cynical here, it doesn't behoove her current RE to encourage her to try with her OE if he/she thought it was a real long-shot since it would just lower his/her SART stats. Given that, I think it is likely she has received good advice given her particular situation and bringing up what your ob/gyn friend said will likely just lead to self-doubt. Good luck to her!
    IUIs #1-3 (1x unmedicated, 2x Clomid) = 2 BFNs, 1 m/c at 7w3d
    IUIs #4-6 (injects) = 3 BFNs
    IVF #1 = BFN
    FET #1 = BFN
    FET #2 = BFN
    IVF #2 = BFP, b/g twins lost at 20w due to partial abruption/PPROM
    IVF #3 = c/p 5w2d
    Long-shot Clomid/Prednisone cycle before next IVF = BFP, our beautiful, healthy girl born 6/26/13!
    ~~
    TTC again March 2014
    FET #3 - May/June 2014
    - all embryos arrested before xfer - back to the drawing board...
    IVF #4 - July/August 2014 
    beta 1 (11dp3dt) 220, beta 2 (13dp3dt) 671, beta 3 (19dp3dt) 10762
  • image Mrkyrain:
    Once the FSH number has a high reading like that it indicates DOR. nbsp;Even when it goes down, it doesn't mean that ovarian reserve has changed. nbsp;You are still working with the same number of eggs. nbsp;Having said this, it doesn't mean that she can't get pregnant. nbsp;Mine was close to 19 when it was tested two years nbsp;ago so it could have been even higher when I got pregnant. nbsp;It is possible to get KU, just less likely than someone who doesn't have egg issues. nbsp;I assume that her RE has gone over the chances. nbsp;


    Ditto this. I would, however talk with her about things I've learned about DOR status. There are other very serious considerations to pursuing your OE once you have DOR. Certainly a big obstacle is a reduced number, but this issue is not the primary concern of TTC with DOR, based upon my personal research. The research I've read with respect to trisomies and m/c rates with DOR patients under the age 35 is staggering and played a huge role as a woman over 35 in our decision to stop cycling with my OE. DOR is a bigger deal than just a numbers game and with a high FSH and a canceled cycle under her belt, she's dealing with DOR.
    Baby girl Lila born 2013.
    Baby boy Henry born 2015.
    Expecting our capstone baby (boy) early March 2018.
  • I wanted to add that I'd say something to a friend if we had a close relationship. I'd also say something only if I had firsthand knowledge of the pertinent facts. And, most importantly, I would tell a friend who was in my shoes because I wish someone could have told me. It would have made my angst with respect to the OE v DE decision much less, and the answer clearer to us sooner.

    It's frustrating to see many women with DOR make these major decisions without having all of the information to consider first. Even our RE didn't really tell us and he conducted a major study on the consequences of IVF with DOR. I guess he wanted us to find our own way? Maybe that's where your friend's doc is coming from. You have to be ready and willing to receive the info. Erg. It's a stinky and tough situation, reb.

    ETA I have a big mouth, so you should take what I've said with a grain of salt. lol
    Baby girl Lila born 2013.
    Baby boy Henry born 2015.
    Expecting our capstone baby (boy) early March 2018.
  • Take what I have to say with a grain of salt as I am angry and bitter but I don't believe that a DOR woman at 42 will have a good egg. Yes, she can do the cycle but statistically, the odds of one of those eggs being chromosomally normal is very slim. 

    TTC #1 since 8/1/10; Me:41 and BRCA1+, DH:46
    DOR (FSH 24.3)/ terrible egg quality ; homozygous MTHFR c677t
    5 IUI's: 2/11 to 6/11 and 1/12= BFN
    OE IVF#1-4 8/11-6/12= all BFN
    DE IVF#1 11/12 bad embryos= BFN
    DE IVF #2 2/13 BFP/Beta hell: m/c 5w6d
    CFNBC 7 months, not doing well; decided on guarantee program at RBA w/frozen DE
    DE IVF #3 1/14  ET 4BB; BFP;M/C 5w1d, incomplete m/c; MVA extraction in ER 7w1d

    DE FET#1 ET 3/1714; BFP, beta 1 3/27= 197, beta 2 3/31= 1586, beta 3 4/7= 13879!!
    First u/s= Twins with HBs at 6w2d! We are Team Pink x 2!!

    K & K born 11/21/14 at 38wks 4 days

    imageimage

    SAIF/PAIF Welcome


    http://waitingforraintostop.wordpress.com

  • image Mrs.McIrish:
    Take what I have to say with a grain of salt as I am angry and bitter but I don't believe that a DOR woman at 42 will have a good egg. Yes, she can do the cycle but statistically, the odds of one of those eggs being chromosomally normal is very slim. 

    I tend to agree and that is basically what my dr friend said in addition to there is a chance it could work.  My IF friend does plan to do PGD.

    Like I said before, she is not a newbie to all this and she has struggled a lot and I hope this does work for her. 

    Thanks Ladies!! 

     

    I am AMA and all tests on H came back normal
    3 failed IVF with OE and 2 failed frozen DE cycles
    Last fresh hail mary DE cycle starting Feb 2013
    PAIF/SAIF always welcome
  • Well, fsh is only as good as ur worst number...so the 9 means nothing.

    I would think her RE should do amh, and get a better pic.  How she moves forward is her call, but the care she is getting sounds suspicious.  Maybe u could point that out, and a 2nd opinion could help her make a more informed decision.

    TTC 12/2009 Dx Severe MFI/azoo 6/2010


    IVF 1 (long lupron): mc 7w4d, D&C 11/23/10


    IVF 2 (antagonist w co cultures): cancelled 2x due to no sperm


    IVF 2.2: ER 6/9/11 3dt of 2 (1 frostie :), BFN

    IVF 3 (EPP w co cultures): 9/2011 (cancelled, irregular pap) LEEP 9/2011

    IVF 3.1 (11/2011) EPP w co cultures: 3dt of 3- BFN Again

    Natural sFET 1/2012: -ET of the "lone wolf (Wolfie)" 1/29

    Beta 2/8 BFP!! Betas: 119 @14dpo, 388 @16dpo, HB 6w2d 131!!

    dx GD @ 28 wks, insulin dependent






    *s/paif always welcome*



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    Can't wait to meet Wolfie!!!

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  • I wouldn't say anything to her.  The fact that she was already prepared to move to DE tells me that she is prepared for the worse in using her own eggs.  If it were me, regardless of my response and outcome at a foreign clinic, I would want to give myself a chance here in the US.  Plus I've had really bad advice from OB/gyn in the past and quite frankly I don't think they have a clue how to get a patient pregnant.  Their expertise is only after the bun is already in the oven.

    TTC #1 since 9/07
    Dx MFI, AMA, Endo, AMH .16
    Lap 10/09 Removed endometrioma, stage IV endo and adhesions
    Lap 2/10 Endometrioma cysts & adhesions returned.
    Ivf #1 4/10 Antagonist, ET Cancelled.
    IVF #2 2/11 A/ACP+E2V C/P
    IVF #3 6/11 Letrozole/Antagonist BFN
    IVF #4 11/11 Low stim Antagonist BFN
    Lap 3/12 Lap & Selective HSG
    Many cycles of Letrozole and LP HCG w/TI and LDN
    IVF #5 8/12 Low stim BFN
    IUI #1 10/12 BFN br> S&PAIFW
  • image Mrs.McIrish:
    Take what I have to say with a grain of salt as I am angry and bitter but I don't believe that a DOR woman at 42 will have a good egg. Yes, she can do the cycle but statistically, the odds of one of those eggs being chromosomally normal is very slim. 

    This is how I feel. But, I think you need to let her find out for herself. It may be one of those things that she needs to cycle one more time for closure. Just be there for her in the end if things don't go her way.  

    Pregnancy Ticker
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